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Four Generations of Nurses
Working Side by Side

Wednesday May 9, 2007
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At a time when the Silent Generation of nurses known for hard work and loyalty is easing into retirement, a wave of optimistic, well-educated RNs are showing up with iPods and traveling shoes.

Dubbed the Millennial Generation or Gen Y, today's younger nurses grew up surfing the Internet and taking part in numerous activities with a network of friends in a supportive, some say pampered, family environment. They tend to be good team players with personal goals, but they're also likely to switch jobs if they feel weighed down by workplace pressures or lack of opportunities, according to experts on generational traits.

For nursing leaders, there's an emerging trend to understand generational differences and be ready to shift gears at any time to keep the workplace running smoothly, says Toni McKenna, RN, DNSc, senior director of clinical leadership with VHA Inc. of Irving, Texas.

Traits in a nutshell

While the generations show far more commonalities than differences, there are certain mindsets influenced by the times, McKenna says. These traits aren't shared by everyone, she adds, and aren't necessarily bad or good — just different. In a nutshell, here's how the generations are defined:

• The Veterans or Silent Generation (born 1922 to 1945): hardworking, loyal, and respect for authority, attributes shaped by the Great Depression and World War II

• Baby boomers (born 1945 to 1960): The children born after World War II make up two-thirds of the nation's work force and come from a rebellious time of anti-war protests and distrust for authority and have a can-do attitude that values recognition for achievements.

• Generation X (born 1960 to 1980): the latchkey kids who learned to adapt and be resourceful from growing up in single-parent households or where both parents worked

• Millennial or Gen Y (born 1980 to 2000): a nurtured, digitally astute generation with strong family support and high career expectations

Engaging employees

McKenna coaches nurse leaders on developing specific strategies for engaging employees, such as recognizing baby boomers for their achievements, or giving cash incentives to Gen Xers for scoring high on quality performance.

"Millennials can multi-task with ease, but they may need help prioritizing," McKenna adds.

Caution against stereotyping

However, while it is interesting and even entertaining to look at the new research on generational differences, caution must be taken to avoid stereotyping people, says Debra Pendergast, RN, MSN, CNAA, chief nurse executive at Mayo Clinic in Scottsdale, Ariz.

Such generalizations as saying that older nurses want a different set of benefits than younger nurses could be inaccurate and put people in "buckets" where they don't belong, she says. She adds that behaviors that show lack of mutual respect — unintended sarcasm, put-downs, and gossip — also foster stereotypes.

"It's important to look for management best practices that honor diversity and mutual respect as core competencies," Pendergast says. "Otherwise, trust issues will arise, and some nurses will feel empowered and others won't."

Focusing on similarities

The topic of generational differences is "on our radar screen," says Chief Nurse Executive Lorie Shoemaker, RN, MSN, CNAA-BC, who oversees nursing activities at the two-hospital Palomar Pomerado Health system in San Diego. "We're part of an aging workforce that needs to embrace the younger generation."

However, rather than dwell on differences between age groups, Shoemaker, who entered nursing in 1974, prefers to focus on similarities nurses share that inspire cooperation and teamwork.

"The basic art and science of nursing hasn't changed for over a century," Shoemaker says. "The lungs and heart are still in the same place and the reason for going into nursing is the same — to provide compassionate patient care."

Expanding technology

One change that has occurred is the emergence of technology, Shoemaker says. Having raised four Gen X children and one from the "nexter," or Y, generation, she knows how easily the 30-something and younger crowd embraces the digital world.

"They're very techno-savvy and demand technology that makes their jobs easier," she says. Meshing their skills with the patient-care experience of nurses whose average age is 47 makes a potent combination for the expansion of evidence-based protocols and electronic health records, she adds.

"Where we get into trouble is when senior nurses don't value the technology skill set that youth brings or where youth doesn't value the wisdom of senior nurses," Shoemaker says.

Her solution is to pair senior and younger nurses in preceptor and mentor programs so they learn to value each other's contributions.

Recruiting challenges

Sandy Haeberle, RN, senior vice president with the Bernard Hodes Group, Healthcare Division, says the Millennial Generation's entry into nursing presents some challenges to recruiters she has talked to.

"These are the kids of the 'helicopter parents' who have hovered over them most of their lives," she says. "They've had everything, and their parents don't let them trip and fall. When they do stumble, parents land the helicopter, fix it for them, and go back to hovering."

This generation is optimistic, talented, and achievement-oriented. Millennials have rarely failed in anything, and they're used to having a strong support group, Haeberle says.

Pinpointing priorities

Nurse managers, on the other hand, can benefit by realizing employees come from different generational mindsets and trying to understand what drives them, Haeberle adds.

For example, many nurses are happier and most productive working three 12-hour shifts and then having four days off to be with their friends and family.

When dealing with an age-diverse workforce, creative communications and flexible feedback on performance are also winning strategies, Haeberle says. Giving nurses a choice of attending a staff meeting in person or virtually via email or an online "chat" room is one way to open new channels.

Expanding choices

Jane Swanson RN, PhD, CNNA, director of the Institute for Professional Nursing Development at Cedars-Sinai Medical Center in Los Angeles, says understanding generational issues is important because there are four age-related cohorts in the workplace for the first time in history.

To accommodate generational differences in learning styles, the institute offers choices to nurses taking educational courses or seminars. For example, nurses could attend a lecture that provides answers to quizzes, or go online for an interactive presentation of the subject.

Swanson also has a Wisdom at Work grant from the American Organization of Nurse Executives to research practice patterns and ergonomics experiences of both nurses older than 45 and younger than 45.

"We try to give a balance to nursing care that embraces the latest equipment and still has the human touch," Swanson says. "I think all generations of nurses are appreciating this technology."

John Leighty is a freelance writer for NurseWeek. To comment on this story, send e-mail to editorca@nurseweek.com.